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a Ce , UNITED STATES CIVIL SERVICE COMMISSION BUREAU OF DEPARTMENTAL OPERATIONS WASHINGTON 25, D.C. March 3, 1900 FILE REFERENCE Se i RCC:MASsdep Federal RPurean of Investigetion _ /) _ Department of Justice x ATTN: Personnel Section In an application for benefits under the Civil Service Retirement Act, it is alleged that the above-named individual performed service as sae oe follows: e _ DEPARTMENT OR AGENCY BUREAU OR BRANCH, ANDO LOCATION = . FBI FEI, Washington, De Ca a POSITIONS HELD PERIODS OF SERVICE (Beginning end ending dates) * : Faom To ‘ . 24-27 8-5-35 For use in connection with this claim, you are requested to furnish by indorsement on the reverse of this form a complete schedule of his or her employment in your office. If the employee was on leave of absence without pay in excess of six months in the aggregate during any calendar year, please state par- f bs ticulars. é If the employee rendered service on 4 w.a.e. basis, the number of, 5 i days actually employed should be shown. 45 4 — 4° a If the service claimed above cannot be verified it pay be necessary — Le to request a pay roll search in the General Accounting Office. You are, - ~ af : therefore, requested to give the disbursing reference if it is available. wr Reference should include the name and symbol number of the disbursing ‘ " officer who made the payment, and any other data which will aid the General Ananunting OF fine ta Pind the deairad infoarmatinan cow ee ts cm — 1 Webel wo & boo wee a eat Oa de de et BOS WS UGE Sincerely yours, af. Le Qa) . Andrew E. Ruddock ' Chief, Retirement Division ale